高龄患者围术期脑卒中的危险因素及预测指标研究

Study on the risk factors and predictive index of perioperative stroke in elderly patients

目的分析高龄患者围术期脑卒中的危险因素并探讨相关血清学指标预测脑卒中的价值。方法收集我院围术期脑卒中且年龄≥60岁的患者48例,采用多因素Logistic回归模型分析围术期脑卒中的危险因素,同时绘制中性粒细胞与淋巴细胞计数比值(NLR)和纤维蛋白原(FIB)预测脑卒中的受试者工作(ROC)曲线。结果多因素分析显示围手术期患者合并有高血压病、糖尿病、脑卒中史、FIB和NLR升高是发生脑卒中的危险因素;同时NLR和FIB预测围术期脑卒中的曲线下面积分别为0.754和0.566,NLR预测脑卒中的最佳诊断点为3.05,敏感度和特异度分别为73.4%和77.2%。结论高血压病、糖尿病、脑卒中史、FIB和NLR升高是围术期脑卒中发生的危险因素,同时NLR可作为一项早期预测指标,对早期发现围术期脑卒中具有一定价值。

Objective To analyze the risk factors of perioperative stroke in elderly patients and to explore the value of related serological markers in predicting stroke. Methods 48 patients with perioperative stroke and age ≥ 60 years old were collected in our hospital. Multivariate logistic regression model was used to analyze the risk factors of periopera tire stroke, and at the same time the ROC curve of the ratio of neutrophils to lymphocyte eount（NLR） and fibrinogen （FIB） in predicting stroke was mapped. Results Multivariate analysis showed that complicated hypertension, diabetes mellitus, stroke history, increased FIB and NLR in the patients during perioperative period were the risk factors for stroke; while the area under the curve of NLR and FIB in predicting perioperative stroke was 0.754 and 0.566 respectively, and the best diagnostic point for NLR in predicting stroke was 3.05. Sensitivity and specificity were 73.4% and 77.2% respectively. Conclusion The history of hypertension, diabetes mellitus, stroke, increased FIB and NLR are the risk factors of perioperative stroke. At the same time, NLR can be used as an early predicting indicator, which has a certain value in early detection of perioperative stroke.